tbuckley/cabot-search huggingface dataset:
Esophageal intramural pseudodiverticulosis: a rare cause of dysphagia
Authors: A. Alhyari, M. Zumblick, P. Stathopoulos, T. Gress, U. Denzer
Journal: Endoscopy (2023)

Abstract Text A 46-year-old man with a history of alcohol abuse and recurrent dysphagia underwent an upper endoscopy at our endoscopy unit. Upon insertion of the gastroscope the patient coughed and a mucosal laceration without deep muscle injury was seen within a stricture in the proximal esophagus. Examination of the remaining esophagus revealed multiple diverticula of varying sizes consistent with esophageal intramural pseudodiverticulosis. On the second gastroscopy after 3 days no resistance was encountered proximally upon insertion of the endoscope. Histology revealed nonspecific inflammatory changes without evidence of eosinophilic esophagitis or candidiasis. The patient’s dysphagia improved gradually.
Cap-assisted endoscopic removal of sharp-edged glass fragments embedded in the esophageal wall after a prisoner's suicide attempt
Authors: C. Sotiropoulos, T. Lourida, G. Geramoutsos, G. Theocharis, K. Thomopoulos, C. Konstantakis
Journal: Endoscopy (2023)

Abstract Text A 43-year-old male prisoner was referred to the emergency department due to reported ingestion of bleach and glass fragments following a suicide attempt. The patient was initially treated based on the national poison center's instructions. After excluding perforation, an emergency upper gastrointestinal endoscopy was performed which revealed 2 wedged triangular fragments of glass in the middle and lower third of the esophagus. A cap-assisted endoscopic technique was used, where after the cap placement on the tip of the scope with the use of forceps the fragments were captured and extracted within the cap to protect the esophageal mucosa from the passage of the sharp edges during extraction [1] [2] [3] [4].
Gel immersion endoscopy facilitates endoscopic hemostasis of Dieulafoy’s lesions in the small intestine
Authors: K. hashimoto, T. Yano, K. Oguro, Y. Ono, T. Kobayashi, T. Tamaru, Y. Funayama, J. Owda, H. Sakamoto, K. L. Alan, Y. Hironori
Journal: Endoscopy (2023)

Aims It is often challenging to treat Dieulafoy’s lesions in the small intestine (Yano-Yamamoto classification Type 2a) due to intermittent and pulsatile bleeding. After spontaneous hemostasis, finding a minute red dot or fibrin plug surrounded by normal mucosa can be challenging. It can be difficult to secure the visual field while performing endoscopic hemostasis of a Dieulafoy’s lesion with active bleeding. The efficacy of gel immersion endoscopy (GIE) during endoscopy for GI bleeding was reported. The efficacy of GIE to treat Dieulafoy’s lesions was retrospectively evaluated.
Energy consumption and power saving options in the endoscopy unit- a single center “green endoscopy” study
Authors: B. Walter, N. Sturm, A. Kalner, T. Seufferlein, M. Müller, M. Wagner
Journal: Endoscopy (2023)

Aims Objective:Anthropogenic climate change is named as the biggest global health threat of the 21st century. Unfortunately, health care system itself and so endoscopy as well significantly contributes to carbon footprint. Waste produced within endoscopic procedures is one aspect. Approaches to generate less land fill waste and more recyclable materials are already initiated. But energy consumption and potential options for power savings within endoscopy are poorly addressed up to now.
Conservative Management of Complex Colorectal Polyps in Patients with Significant Co-morbidities
Authors: R. Ranjan, C. Westwood, M. Rutter
Journal: Endoscopy (2023)

Aims Polypectomy carries risks, especially in elderly and co-morbid patients. We aimed to assess conservative management of complex colorectal polyps and suitability of co-morbidity indices in decision-making.
Effectiveness and Safety of 1L Polyethylene Glycol Plus Ascorbic Acid Preparation in Patients Aged ≥65 Years in a Large Real-World Population
Authors: V. Lorenzo-Zúñiga García, M. A. Pantaleón, D. Carral, E. Perez-Arellano, F. Sábado, A. Lopez-Cano, S. Machlab, B.J. Gómez Rodríguez, R. Gorjão, S. Rodriguez, J.M. Esteban López-Jamar, C. Arieira, J. Cotter, F. Akriche, C. Turbi Disla
Journal: Endoscopy (2023)

Aims To evaluate the effectiveness/safety of 1L polyethylene glycol plus ascorbic acid preparation (PEG+ASC) in elderly patients (≥65 years) in a large real-word population.
Radiofrequency ablation for dysplastic Barrett's esophagus: a retrospective study of efficacy and tolerance
Authors: N. David, R. Michel, C. Franck, R. Noemi, L. Quénéhervé
Journal: Endoscopy (2023)

Aims Radiofrequency ablation (RFA) is a treatment indicated for the destruction of dysplastic Barrett's oesophagus (BE), either in case of flat mucosal dysplasia without visible lesion or after endoscopic resection. The main objective of this study was to evaluate RFA eradication of dysplastic BE in the long term.
Factors influencing the length of hospital stay in patients with acute lower gastrointestinal bleeding
Authors: V. Papastergiou, N. Paparizou, F. Almpani, A. Tsatsa, A. Mountaki, K. Koustenis, C. Veretanos, E. Beka, T. Georgiadi, K. Arvanitis, D. Kozompoli, I. Mylonas, L. Karaouzas, G. Nousias, K. Paganou, A. Konti, F. Tsourbarka, M. Zachariadi, E. Vienna, K. Katopodi, C. Hatzievangelinou, A. Christidou, M. Mela, K. Varytimiadis, E. Archavlis, N. Viazis, G. Mantzaris
Journal: Endoscopy (2023)

Aims Acute lower gastrointestinal bleeding (ALGIB) is associated with significant clinical and economic burden. We evaluated factors correlating with prolonged hospital stay (PHS) in patients with ALGIB.
Feasibility of esophageal salvage endoscopic submucosal dissection for the patient of esophageal neoplasm with prior radiation or ablation therapy
Authors: M. Koseki, M. Nishimura, S. Satoi
Journal: Endoscopy (2023)

Aims Endoscopic submucosal dissection (ESD) of early esophageal tumor is well established, now has been getting popularity in all over the world. ESD for the esophageal neoplasm with prior radiation or ablation therapy can be technically challenging because of post-radiation/ ablation changes in the submucosal layer of the esophagus. The aim of this study is to assess the feasibility of salvage ESD in patients with prior radiation therapy (RT) and/or radiofrequency ablation (RFA) therapy.
An unusual case of pancreatic mass
Authors: A. Mauriello, R. C. Stasio, F. Fimiano, F. Castellano, M. Gesualdo, M. T. Staiano, E. Dall'Amico, C. Pitino, M. Sacco, C. G. De Angelis
Journal: Endoscopy (2023)

Abstract Text The integration of Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) in a single endoscopic session was named endoscopic ultrasound retrograde cholangiopancreatography (EURCP). There were many applications of the EURCP concept for diagnosing and treating biliopancreatic disease. This case report was one example of this technique and explains how EURCP is the best way to obtain a good diagnosis and efficacy treatment in a single-operative endoscopic session, especially in selected clinical cases.
Management of gastroparesis refractory to GPOEM by EUS-guided drain associated gastroentero-anastomosis: a new promising option
Authors: J. M. Gonzalez, V. Vitton, M. Gasmi, M. Barthet
Journal: Endoscopy (2023)

Abstract Text We present a short series with videocase of patients successfully treated by EUS-GEA with drain assisted technique, for gastroparesis (RG) nonresponding to GPOEM. All patients were followed using GCSI score.Six patients were included, aged 20 to 70 years. The median baseline G-CSI was 4.4 [3.3; 5], the time to recurrence of symptoms was 9 months [0; 48]. Technical success was achieved in 100% of cases, without adverse event.Clinical efficacy rate was 100% after a median follow-up of 6 months [3; 16]. The GCSI at 3 months was [0 0; 2.9], 3 patients had disappearance of symptoms.In conclusion, this report suggests feasibility, safety and efficacy of EUS-guided GEA for managing gastroparesis refractory to all therapies including GPOEM.
MELD score accurately predicts 5-day failure to control variceal bleeding by endoscopic band ligation
Authors: V. Papastergiou, E. Beka, A. Mountaki, C. Veretanos, D. Kozompoli, I. Mylonas, N. Paparizou, F. Almpani, T. Georgiadi, K. Arvanitis, K. Koustenis, A. Tsatsa, L. Karaouzas, G. Nousias, K. Paganou, M. Zachariadi, A. Konti, F. Tsourbarka, E. Vienna, K. Katopodi, C. Hatzievangelinou, M. Mela, A. Christidou, K. Varytimiadis, E. Archavlis, N. Viazis, G. Mantzaris
Journal: Endoscopy (2023)

Aims Predictors correlating with failure of endoscopic band ligation (EBL) are paramount for the improvement of prognosis in patients with cirrhosis and acute variceal bleeding (AVB). We evaluated the model-for-end-stage-liver-disease (MELD) as predictor of 5-day treatment failure in cirrhotics with AVB undergoing EBL.
Laparoscopic-Endoscopic Cooperative Surgery (LECS) for full thickness resection of gastric gastrointestinal stromal tumors (GISTs)
Authors: F. Tomba, A. Massella, T. Togliani, M. Bencivenga, S. Giacopuzzi, A. Cerofolini, M. Franceschi, G. De Manzoni, L. Rodella
Journal: Endoscopy (2023)

Aims In Western countries gastric GISTs are treated with laparoscopic wedge resection (LWR). This procedure is technically challenging in some gastric sites, so it's difficult to achieve minimal and curative resection margins or large resections are needed. In Eastern countries, Laparoscopic Endoscopic Cooperative Surgery (LECS) has been proposed as a new treatment for gastric GISTs. For ulcerated GISTs a modified technique (Non-exposed Endoscopic Wall-inversion Surgery: NEWS) has been developed to avoid peritoneal tumor seeding. This prospective study evaluates the outcomes of these procedures in our center.
Musculoskeletal injuries in gastro-enterology endoscopists: prevalence and risk factors among a monocentric Moroccan center
Authors: H. Aouroud, F. E. Lairani, M. Aouroud, A. Ait Errami, S. Oubaha, Z. Samlani, K. Krati
Journal: Endoscopy (2023)

Aims Digestive endoscopy represents an important part of the workload of gastroenterologists. However, little attention is paid to the ergonomic aspects of endoscopy. The aim of our study was to evaluate the prevalence of these disorders among our center and to determine the different risk factors.
A voting-based ensemble model for improved automated classification of colorectal polyps including sessile serrated lesions
Authors: B. Callaerts, T. Eelbode, P. Sinonquel, A. Jans, F. Maes, R. Bisschops
Journal: Endoscopy (2023)

Aims Since sessile serrated lesions (SSL) were introduced, multiple AI studies have tried to classify them alongside hyperplastic (HYP) and adenomatous (ADN) polyps using machine learning, with varying results. A major hurdle for the classification of SSL is the low prevalence and difficult endoscopic recognition. Furthermore, the classification based on histology can also be subjective, as demonstrated by the inter-rater variability amongst pathologists. This study aims to improve the baseline training method for classification by training multiple models on subtasks before taking an ensemble vote for final classification.
Environmental impact of endoscopic submucosal dissection versus piecemeal resection for large colonic adenomas : a post hoc analysis of the resect colon study
Authors: R. Grau, P. Mathieu, P. J. Cottinet, J. Jacques, T. Wallenhorst, C. Jean-Baptiste, L. Vincent, C. Stanislas, R. Jerome, L. Romain, S. Marion, L. Sarah, R. Florian, B. Maximilien, A. Jeremie, A. Belle, L. Hugo, D. Martin, T. Ponchon
Journal: Endoscopy (2023)

Aims Last ESGE guidelines supposed that endoscopic peacemeal resection (P-EMR) are less impacting the environment than endoscopic submucosal dissection (ESD) for colonic adenoma’s resection. The prospective randomized multi centric RESECT study compared resection of colonic adenomas > 25 mm by P-EMR or ESD. In this post-hoc analysis we investigated the environmental impact of these procedures.
Gender impact to endoscopic sleeve gastroplasty outcomes
Authors: M. De Siena, G. Polidori, B. Vincenzo, V. Pontecorvi, M. V. Matteo, G. Carlino, G. Palumbo, C. Massari, N. Antonini, G. Giannetti, C. Spada, G. Costamagna, I. Boskoski
Journal: Endoscopy (2023)

Aims Endoscopic sleeve gastroplasty (ESG) is established as effective and mini-invasive procedure for obesity. Patients undergoing bariatric procedures in 80% of the cases are females. It is known that gender plays a role in several metabolic networks related to obesity; however no studies have investigated the gender impact on obesity after ESG. The aim is to evaluate the gender impact on long-term weight loss outcomes after ESG in patients treated in our bariatric unit.
Fully vs. partially covered self-expandable metal stents for esophagogastric anastomotic leak
Authors: R. Ortigão, P. Cláudia, M. S. Inês, B. Pedro, D. R. Mario, D. Libanio
Journal: Endoscopy (2023)

Aims Self-expandable metal stents (SEMS) are a minimally invasive treatment for anastomotic leaks (AL). Our aim was to compare clinical and safety outcomes of fully covered (FC) and partially covered (PC) SEMS [1].
Endoscopy in patients with COVID-19 infection. Indication, findings and safety for the staff of the endoscopy unit
Authors: N. Viazis, E. Vienna, V. Papastergiou, E. Archavlis, M. Mela, A. Christidou, K. Varytimiadis, C. Hatzievangelinou, K. Katopodi, C. Veretanos, K. Koustenis, G. Nousias, A. Mountaki, F. Almpani, A. Tsatsa, E. Beka, K. Arvanitis, T. Georgiadi, I. Mylonas, D. Kozompoli, N. Paparizou, L. Karaouzas, A. Konti, M. Zachariadi, F. Tsourbarka, K. Paganou, G. Mantzaris
Journal: Endoscopy (2023)

Aims To record the indications and how safe endoscopies are for COVID-19 positive patients for the medical and nursing staff of the Endoscopy Unit.
The Utility of pancreatic cyst fluid (PCF) glucose levels in the diagnosis of suspected mucinous pancreatic lesions
Authors: M. Shibeika, J. Iqbal, S. Farid, V. Lekharaju, S. Mahmood
Journal: Endoscopy (2023)

Aims To identify the role of PCF glucose as an adjunct to carcinoembryonic antigen (CEA) in differentiating mucinous and non-mucinous cystic lesions, especially those with an indeterminate PCF CEA level (5–192 ug/l), given the variable sensitivity and specificity of CEA in isolation.
Identification of GNAS and KRAS in EUS-guided fluid samples from the main pancreatic duct (MPD) accurately discriminates Intraductal Papillary Mucinous Neoplasm (IPMN) from other conditions with MPD dilatation
Authors: G. Soy, V. Villagrasa, I. Archilla, I. K. Araujo, O. Sendino, H. Cordova, M. Lopez, M. Cuatrecasas, G. Fernandez-Esparrach, D. Colomer, A. Gines, E. C. Vaquero
Journal: Endoscopy (2023)

Aims To evaluate the diagnostic yield of GNAS or KRAS mutation analysis in EUS-guided liquid samples from the MPD to recognize IPMN in patients with dilated MPD.
ThinPrep cytologic evaluation of brush tip in indeterminate biliary strictures
Authors: M. Montori, S. Vastaroli, M. E. Argenziano, D. Morichetti, L. Daretti, F. Marini, E. Bendia, L. Maroni
Journal: Endoscopy (2023)

Methods 15 (M:F 9:6) consecutive patients with indeterminate biliary stricture were evaluated (mean age 67,5 years). All patients underwent brushing of the stricture during ERCP. For each patient, samples for standard cytology preparation (fixed in alcohol 95° and coloured with Modified Papanicolaou staining technique by the cytopathology laboratory) and brush tips (cut and immersed entirely in the PreservCyt solution for Thin Prep) were collected. All samples were evaluated according to the Papanicolaou system for reporting pancreaticobiliary cytology diagnostic categories.
Comparative study of esd and surgical resection for gastric subepithelial tumors Originated from muscularis propria
Authors: C. B. Ryu, M. S. Lee, J. Y. Bae
Journal: Endoscopy (2023)

Aims The aims of this study were to compare endoscopic subtumoraldissection(ESD) with surgical resection for the removal of GSET-PM.
Endoscopic full-thickness resection of colorectal lesions: a 3-year experience of a Portuguese tertiary centre
Authors: J. Correia, J. Rodrigues, M. M. Estevinho, P. Mesquita, T. Freitas
Journal: Endoscopy (2023)

Aims Endoscopic full-thickness resection (EFTR) allows definitive diagnosis and treatment of complex colorectal lesions not amenable to conventional endoscopic resection. The authors present the results of the largest Portuguese colorectal EFTR registry.
Efficacy and safety of capecitabine and temozolomide (CAPTEM) in advanced gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NEN): a systematic review and metanalysis
Authors: N. Bina, M. Tacelli, S. Massironi, C. Gallo, C. Stornello, P. Arcidiacono, G. Capurso
Journal: Endoscopy (2023)

Aims The combination of capecitabine and temozolomide (CAPTEM) is increasingly used for advanced gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NEN), but evidence on results is sparse.We conducted a systematic review and meta-analysis to assess efficacy and safety of CAPTEM in advanced GEP-NEN
Endosonographic characteristics of the lower esophageal sphincter (LES) in achalasia patients compared to normal individuals and their associations with manometric findings and post-myotomy response
Authors: P. Rattanachaisit, S. Arayakarnkul, P. Mekaroonkamol, K. Tiankanon, R. Pittayanon, J. Sirimongkolkasem, P. Pitisuttithum, T. Patcharatrakul, S. Gonlachanvit
Journal: Endoscopy (2023)

Aims We aimed to compare the characteristics of LES in patients with achalasia and normal individuals using endoscopic ultrasound (EUS). The secondary aim was to evaluate their prognostic value on myotomy orientation during peroral endoscopic myotomy (POEM).
Eosinophilic Gastrointestinal Disorders in Hypereosinophilic Syndrome: a multidisciplinary Case Report
Authors: C. L. Pugliano, S. M. Milluzzo, A. Filippini, R. Bazzani, G. Rossi, P. Cesaro, C. Spada
Journal: Endoscopy (2023)

Methods A 35-year-old woman referred to the emergency department with vomiting, hyporexia, abdominal distension and worsening of her chronic diarrhea.
It can get in, but can it get out? A surprising finding in the stomach
Authors: L. Triki, M. Fernandez y Viesca, A. Lemmers, J. Deviere, M. Arvanitakis
Journal: Endoscopy (2023)

Abstract Text Our case reports the ingestion of a vinyl glove, which upon exposure to gastric acidity lost its flexible properties and solidifies. The mechanism is based on the formation of a double-bridge bonding of hydrogen due to the contact with HCL present in the gastric fluid.
Site check colonoscopy after Endoscopic Mucosal Resection (EMR): Driving down recurrence rates
Authors: E. Keating, J. Leyden, H. Martir, C. Lahiff
Journal: Endoscopy (2023)

Aims En bloc resection is associated with low recurrence rates for colorectal polyps. Piecemeal techniques such as EMR are more accessible for larger lesions and are favoured in most European centres. Recurrence rates are an important quality indicator for EMR.
Should digestive endoscopy be performed in patients with gastrointestinal luminal wall thickening found on computed tomography ?
Authors: S. Souissi, N. Ben Mustpha, L. Asma, S. Laabidi, F. Monia, S. Meriem, J. Boubaker
Journal: Endoscopy (2023)

Aims The aim of our work was to study the contribution of digestive endoscopy in the etiological assessment of bowel wall thickening visualized on computed tomography (CT) scans.
PBC-Mayo Risk Score is predictive of oesophageal varices in patients with primary biliary cholangitis
Authors: R. Tababi, S. Mrabet, I. Akkari, J. E. Ben
Journal: Endoscopy (2023)

Aims PBC-Mayo Risk Score is a prognostic model that includes clinical and biological features at baseline. It was developed to predict survival in patients with primary biliary cholangitis (PBC). The aim of this study was to evaluate the performance of Mayo score in predicting oesophageal varices (OV).
Artificial intelligence system using white light for real-time optical characterization of colonic polyps
Authors: I.M. B. Bergna, E. Rondonotti, S. Paggi, A. Amato, A. Andrealli, G. Scardino, G. Tamanini, N. Lenoci, G. Mandelli, N. Terreni, L. Ambrosiani, E. Filippi, F. Radaelli
Journal: Endoscopy (2023)

Aims To prospectively evaluate the clinical feasibility as well as diagnostic performances of AI-alone and AI-assisted OD of DCPs in a real-life setting.
Unexpected evolution after successful colonic perforation closure during endoscopic mucosal resection (EMR)
Authors: E. Pijoan Comas, M. Alburquerque Miranda, J. Gelonch Romeu, G. Garcia Continente, R. Palhua Flores, A. Smarrelli, A.L. Vargas García, C. E. Ledezma, M. Figa Francesch, F. González-Huix Lladó
Journal: Endoscopy (2023)

Abstract Text A 65-year-old male underwent surveillance colonoscopy after endoscopic resection of 3 colorectal Carcinoma-in-Situ and low-risk adenomas. In transverse colon, a Paris-Is/Kudo-Vi polyp, 45mm in size, with wide base and located over a fold was found. Since histopathology report from a superficial biopsy described a tubulovillous adenoma with high-grade-dysplasia an EMR was scheduled. During EMR a perforation with active bleeding occurred which was closed with 8 clips that in turn achieved hemostasis. Two hours after, refractory hypotension and mild abdominal pain without peritoneal signs appeared. There is showed a video about an unexpected evolution after successful colonic perforation closure during EMR.
Treatment of an esophageal perforation in a high-risk elderly patient: A novel use of a through-the-scope suturing system
Authors: R. Reicher, M. Shnell, D. Ben-Ami, A. Philips
Journal: Endoscopy (2023)

Abstract Text In this case a 90 year old patient suffered an iatrogenic esophageal perforation during intubation attempt for elective surgery. She was diagnosed with a 3 cm tear just below the upper esophageal sphincter. Due to her high surgical risk and high morbidity associated with open surgical exploration, we offered a novel approach using the X-Tack device (Apollo endosurgery, Austin TX). We placed the tacks 3mm from the defect margin, distal to proximal. Defect closure was confirmed by later inssuflation and fluoroscopy. There was no apperent infection in the neck or mediastinum and no further intervention was needed for source control. Unfortunately the patient deceased on POD 28 due to ventilator pneumonia [1] [2] [3] [4] [5] [6] [7] [8] [9].
Biliopancreatic adverse events after pancreaticoduodenectomy: preliminary results of endoscopic management with pediatric colonoscope
Authors: M. Capasso, M. Mutignani, L. Dioscoridi, M. Bravo, F. Pugliese, M. Cintolo, G. Bonato, D. Donnarumma, E. Forti
Journal: Endoscopy (2023)

Aims Aim of the study is to evaluate technical and clinical success of ERCP performed for biliopancreatic adverse events after pancreaticoduodenectomy (PD) using a wide caliber operative working channel (3.8 mm) pediatric colonoscope.
Artificial intelligence as a support system for real-time colon preparation assessment during colonoscopy
Authors: A. Martinez-Alcalá, G. G. Carmen, O. Ignacio, K. Mönkemüller, J.G. A. Enrique, S. G. Patricia
Journal: Endoscopy (2023)

Aims The interest in evaluating and quantifying colonoscopy quality has increased over the last few years. However, the quality criteria in many cases are either subjective or require a manual process, making them difficult to implement. We aimed at obtaining an objective quantification of the bowel preparation rate using the BBPS in real-time by employing an AI-system that automatically detects the cleanliness of the intestinal mucosa using convolutional neural networks
A “complicated” case of recurrent pancreatitis
Authors: N. Belluardo, S. M. Milluzzo, E. Tettoni, N. Olivari, G. Viviani, L. Minelli Grazioli, P. Cesaro, C. Spada
Journal: Endoscopy (2023)

Aims A man with chronic calcific pancreatitis was hospitalized for a new episode of acute pancreatitis (AP). CT showed a pseudocyst in the head of the pancreas, without apparent communication with the main pancreatic duct (MPD). A conservative treatment was decided.
Experience of EUS versus MRCP in diagnosing Pancreaticobiliary Pathology in a District General Hospital
Authors: J. Ali, M. Shariff, R. Prawiradiradja, S. Ghouse, V. Vakeeswarasarma, P. Wolfson
Journal: Endoscopy (2023)

Aims We evaluated Endoscopic Ultrasound (EUS) versus Magnetic Resonance Cholangiopancreatography ( MRCP) outcomes in patients presenting with suspected Pancreaticobiliary pathology.